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DIVINE IV AND WELLNESS
NPI 1952771024
Nurse Practitioner - Family in Chandler, AZ

Active since October 02, 2015CLIA 03D2343084 · Waiver
3930 S ALMA SCHOOL RD STE 10, CHANDLER, AZ 85248(480) 718-1444(480) 718-7729 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 8, 2024, May 4, 2023, Sep 26, 2022 and 3 more (6 updates tracked since 2015).

About Divine Iv And Wellness NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIVINE IV AND WELLNESS (NPI 1952771024) is a healthcare organization registered as a family in Chandler, Arizona and active in the NPI registry since October 2015. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Joost Berkhout, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1952771024
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameEAST VALLEY JOINT CLINIC LLC
Location Address3930 S ALMA SCHOOL RD STE 10Chandler, AZ 85248-4510
Mailing Address3930 S Alma School Rd Ste 10Chandler, AZ 85248-4510 · (480) 718-1444 · Fax (480) 718-7729
Phone(480) 718-1444
Fax(480) 718-7729
Organization SubpartNo
Authorized OfficialJoost BerkhoutManaging Member · (480) 718-1444
Enumeration DateOctober 2, 2015
Last NPPES UpdateMay 8, 20246 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1952771024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · AP5244
3930 S ALMA SCHOOL RD STE 10, Chandler, AZ 85248
Open in Google Maps ↗

Other Names 1

Doing Business AsDivine Iv And Wellness

Other Identifiers 1

Medicaid100091AZ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2343084

East Valley Joint Clinic LLC · Chandler, AZ
Active · expires Apr 30, 2028
CLIA Number03D2343084
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorAmy S. Berkhout
Laboratory Phone(480) 488-9558
Laboratory LocationEast Valley Joint Clinic LLC3930 S Alma School Rd Ste 10, Chandler, AZ 85248
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER L KASHMER
Nurse Practitioner
3930 S ALMA SCHOOL RD STE 10
CHANDLER, AZ 85248
Maricopa County (480) 488-9858

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Valley Joint Clinic LLC's NPI number?

The NPI number for East Valley Joint Clinic LLC is 1952771024. It was assigned to this organization in the NPPES registry on October 2, 2015. The provider is doing business as Divine IV And Wellness.

Where is East Valley Joint Clinic LLC located?

East Valley Joint Clinic LLC is located at 3930 S Alma School Rd Ste 10, Chandler, AZ 85248. The listed phone number is (480) 718-1444.

What is East Valley Joint Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does East Valley Joint Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2343084) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Valley Joint Clinic LLC was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.